Communicating on stuff that matters

Main Menu

Tory ‘smarm offensive’ can’t hide real cause of NHS crisis

Today’s TV and radio news has been awash with government mouthpieces in a mind-boggling attempt to cast the NHS crisis as the result of ‘poor leadership’ at Trust and GP level.

This ‘smarm-offensive’ – one after another superior, plummy-voiced talking head, all sounding like the management-type of consultant rather than the medical type that might have some credibility – has been rolled out in a desperate attempt to nullify the news that the NHS Trust responsible for one of the UK’s largest teaching hospitals, has been placed in ‘special measures’.

St George’s University Hospitals NHS Foundation Trust has been rated ‘inadequate’, with the Care Quality Commission (CQC) commenting specifically on the deterioration in its services over the last two years – making clear that this is a phenomenon that has happened entirely on the Tories’ watch.

Both hospitals run by the Trust were failed on numerous points and a CQC ‘warning notice’ was issued.

For the Tory government, the fact that the crisis afflicting the NHS is claiming as its victim even one of our leading hospital Trusts requires urgent ‘spinning’.

The thrust of the attempted misdirection has been to blame ‘poor leadership’ for the problems at St George’s and ‘some’ other hospitals and to point to what NHS England chief Simon Stevens calls ‘vanguards’ – a small and, as we’ll see, dwindling number of NHS Trusts that are not struggling, claiming that these few are ‘doing well’ because of great leadership that the others need to copy.

This is utterly disingenuous.

The drowning pool

As even a cursory examination of the facts will show, Trusts that are not drowning in debt and failing because they’re under-resourced are not a vanguard – they’re just the last to drown.

Imagine 10 men in a row, all chained to the bottom of a swimming pool that the villain is fast filling with water. The shortest drowns first, the tallest last. None are thriving.

The pool is the NHS. The water is debt and resource-starvation. The victims are our hospitals and health centres.

And the villains are distracting from the crime they’re committing by pointing at the few tall ones not yet under water and calling them ‘vanguards’ that the poor drowning bastards should be emulating.

The rising water-level

The graphic below shows the levels of debt/surplus over the last 3 complete years in the NHS in England (NHS funding in Scotland, Wales and Northern Ireland is devolved):

It paints a shocking picture. From a universally healthy situation in 12/13 with every area in surplus, in just a couple of years the NHS has become almost universally in debt, thanks to chronic and worsening underfunding, combined with the snowballing impact on the NHS of swingeing cuts to social care funding.

Underfunding means that even the best efforts of staff – St George’s scored ‘outstanding’ for caring – cannot plug ever-multiplying and -widening holes.

And, while the 2015/16 year is only about half-way through, we’ve already seen skyrocketing Accident & Emergency waiting times that are set to smash all records this winter, rising by 545% since the Tories came to power.

St George’s is merely one of 18 NHS Trusts already so far under that they are in ‘special measures’.

Yet the Tories continue to insist that they have “given the NHS what it asked for”.

A crack in the dam?

Health Committee Chair and GP Sarah Wollaston MP

But the Tories’ united façade on the lie is cracking. Conservative MP Sarah Wollaston, a former health minister, still Chair of the Commons Health Committee and herself a GP, along with the committee she chairs, last week called out Theresa May, Health Secretary Jeremy Hunt and Chancellor Philip Hammond on their false NHS funding claims.

Wollaston pointed out that the £10 billion extra they say they’re injecting into the NHS is at best £4.5 billion – and probably even less than that.

She even wrote them a letter to make sure they understood her and her committee’s conclusion from interviews with a range of NHS finance managers as well as Trust Chief Executives and Hunt himself:

Her frankness had Hunt wriggling like a worm on a hook in the Commons, trying to maintain the claim while saying, in effect, ‘we didn’t actually mean extra‘.

You’ll hear a lot today and in coming days about NHS ‘leadership’; about ‘vanguards’ and the need for struggling Trusts to ‘learn from the best’. It’s an absolute red herring.

The Tories are aiming for charm but can only manage smarm – because their insincerity can’t successfully be hidden. The facts are clear and, as the map above shows, the struggles of our NHS have nothing to do with ‘poor leadership’.

They’re not waving, they’re drowning – and even the so-called ‘vanguards’ are only the taller ones waiting to go under.

We in Gloucestershire did some research into how many hospitals have been closed down over the last 20 or so years, (shrinking the state) 23 hospitals major and cottage, so when the Tories say about the shortage of beds due to an aging population, remind them of how many hospitals were closed in your area, and how many are now housing estates.

If they then reply that some hospitals were rebuilt, just look at the difference in bed capacity, as an example, they closed a Tewkesbury cottage hospital with 48 beds then reopened a New Build Hospital with only 20 beds, of course they might say that is due to advances in medicine, but we know it is nothing of the sort, but they do make nice bite sized chunk hospitals, which can be readily sold to the private sector.

Interesting that one of these ‘vanguard’ trusts – Salford Royal – hasn’t been getting more negative press. The chief executive presides over a trust that is in massive debt and is cutting corners in an attempt to save money – a number of low-paid staff (NHS pay grades 1 and 2, domestic staff and administrative clerks) were either outright sacked or were constructively dismissed early this year. The latest to go are the catering staff who will also be constructively dismissed as the trust moves to cook-chill food when they already spend far less on patient food than neighbouring trusts. Dalton produced a pointless report about the NHS which existed solely to prop-up the Tory way of managed decline, He has also headed the failed junior doctor negotiations. Rumour inside the hospital is that he was given his knighthood after being originally promised the NHS England chief’s job, but I haven’t heard any more about that in a while. He’s also now doing something with a neighbouring trust, Pennine Acute, but I fail to see how someone who has brought his own hospital to the very brink of ruin would be able to improve a different, more complex trust (four hospitals versus one).
He trousers a 250k salary for all this, something that has to be signed off by central government and continues to be so despite the state of his own hospital. How he’ll fair now his mate Cameron is out of the picture is anyone’s guess, but there is something unsavoury about it all.